| Summary: | 碩士 === 輔仁大學 === 公共衛生學系碩士班 === 96 === Abstract
Introduction: Electrocautery is widely used to cut and coagulate tissue during surgery in the operating room. A visible smoke with unpleasant odor is produced by electrocautery to pyrolysis tissue. It’s so-called “electrocautery smoke”. Electrocautery smoke contains several mutagens and carcinogens. This study intends to quantify certain chemicals with unpleasant odor and hazard in the electrocautery smoke. Meanwhile, the correlation between the concentrations and the factors included the type of diagnosis, surgery, patient’s BMI, suction condition, using electrocautery time and energy will be analyzed.
Method: This study was conducted in a medical center hospital of Taipei and focused on the breast surgeries. The investigated chemicals included toluene, styrene, o,m- xylenes, phenol, acrolein and furfural. The electrocautery smoke was collected by different samplers to investigate the concentrations of target chemicals simultaneously. The samplers were SKC 575-002 passive sampler for toluene, styrene and xylenes; SKC active samplers: ST 226-95 (XAD-7), ST 226-118 (XAD-2), SKC 226-01 (charcoal) for phenol, acrolein and furfural respectively. All samplers were assembled in a chamber system and the sampling probe was located at approximately 2 ~ 3 cm from the tip of diathermy pencil. Gas Chromatography-Mass Spectrometer (GC-MS) was utilized for qualification and quantitation purposes. For each sample, the personal (patient) data, surgery, suction, using electrocautery time and energy were recorded for further analyzed.
Result: Five individual samples and five cumulated samples were collected. The concentrations of styrene, o,m-xylenes, phenol, acrolein and furfural were lower than lowest quantitation levels（LQLs）in all samples. Toluene was identified in nine samples. The toluene concentration ranges of individual samples were 2.48 mg/m3 ~ 5.50 mg/m3（0.65 ppm ~ 1.45 ppm）and cumulated samples were 1.80 mg/m3 ~ 22.00 mg/m3（0.47 ppm ~ 5.80 ppm）. All measured concentrations of toluene are lowered than the 2006 ACGIH TLV-TWA, 50 ppm.
Conclusion: No correlation between the chemical concentrations and the type of diagnosis, suction system, using electrocautery time and energy were established in this study. However, the patient’s BMI and type of surgery might affect the toluene concentrations. More research on odor materials of electrocautery smoke should be performed.
Keyword: electrocautery smoke, toluene, styrene, o,m-xylenes, phenol, acrolein,
furfural, GC-MS.
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